As Budget Talks Resume, Parties May Face Tough Decisions On Medicare, Other Entitlements

With the ink hardly dry on the deal providing short-term funding to reopen the government and to raise the debt ceiling, negotiators dived into the next round of fiscal talks. Media reports cast doubt on the possibility of a grand bargain, while Medpage Today suggests the latest deal muddled the prospects for an SGR fix.

The New York Times: Two Parties Start Work To Avoid Repeat Crisis
By definition, common ground suggests no grand bargain, which would require a much more difficult trade-off where they fundamentally differ — higher tax revenues that Republicans oppose, in exchange for reductions in Medicare, Medicaid and Social Security that Democrats vow they will not entertain without curbs on tax breaks for wealthy individuals and corporations (Weisman and Calmes, 10/17).

The Washington Post: President, Congress Leave One Crisis Behind But Face Long Road To Budget Deal
The Democrats' budget would restore funding to federal agencies by replacing deep automatic cuts known as the sequester, in part with a large infusion of new tax revenue from the rich. The Ryan budget would not raise taxes and would balance in 10 years, but only by canceling the benefits of the Affordable Care Act while keeping its tax hikes and Medicare cuts. Ryan would also cut spending by domestic agencies to levels so low that even some House Republicans balked at approving funding bills based on his framework. … Rather than trying to hash out a full budget blueprint, many lawmakers and independent analysts expect the conference committee to focus on the most urgent issue facing Congress: funding federal agencies through fiscal 2014. … To avoid increasing deficits, they proposed adopting a range of proposals from Obama’s most recent budget request, such as raising Medicare premiums for high-income seniors and requiring federal workers to contribute more to their retirement (Montgomery and Goldfarb, 10/17).

Kaiser Health News: Tough Medicare Decisions Await Bipartisan Budget Panel
The deal President Barack Obama, Republican and Democratic lawmakers reached to reopen the federal government and raise the debt ceiling includes a bipartisan panel charged with producing a long-term budget agreement. … Both parties have agreed on some Medicare changes, including asking wealthier beneficiaries to pay more for their coverage. They disagree on others, such as increasing the Medicare eligibility age. Democrats won’t agree to any major overhaul of Medicare unless Republicans agree to raise taxes, which they have rejected (Carey, 10/17).

Medpage Today: Budget Deal Muddles SGR Fix
As the dust settled following yesterday's last-minute budget deal to avert a federal government's default, a frightening fact emerged for the nation's doctors. It might be tougher to delay for yet another year the planned cuts physicians face under Medicare's sustainable growth rate (SGR) formula. Physicians face a 24.4% cut for Medicare payments in 2014 unless Congress acts to avert it. Hear me out. With the federal government funded till Jan. 15 and no natural bill to attach a one-year SGR patch to, what mechanism is left for Congress to take action? (Pittman, 10/17).

The Wall Street Journal’s Washington Wire: Unions Warn Lawmakers On Budget Cuts
With the federal government back in operation, union officials wasted no time stating their demands for future congressional budget talks: no cuts to Social Security, Medicare or Medicaid benefits and repeal the across-the-board budget cuts known as sequestration (Trottman, 10/17).

Politico: Mitch McConnell Defends Deal, Slams Obamacare Tactics
Using a football analogy, McConnell said he got the ball on his own two-yard-line with a “shaky” offensive line and had to cut a last-ditch deal with Senate Majority Leader Harry Reid to end the crisis, no matter how unappealing to many in his party. Despite acting as a chief deal-maker in recent years during government crises, it was unclear the role McConnell would play until the final days of the bitter fight (Raju, 10/17).

The New York Times: From The Right, Despair, Anger And Disillusion
Many conservatives described a dispiriting gap between conservative ideals, which they believe inspire widespread agreement, and conservative tactics, which do not. The failure to stop the health care plan left Republicans like Ms. Naples pessimistic and disillusioned. "I’m just totally blown away by everything," she said. "I don’t know what’s right and what’s wrong anymore." Still, for many Wednesday night’s vote had to play out as it did, because there was no other alternative (Robertson, 10/17).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.